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Flashcards in P10 - Pulmonary pathology Deck (56)
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1

What are clinical presentations of lung disease?

• Cough, wheeze
• Breathlessness (dyspnoea)
• Chest pain (often due to pleural disease)

2

Are the lungs themselves sensitive to pain?

No- but the chest wall is

3

What are the 2 functional classifications of lung disease?

-Obstructive
-Restrictive

4

Describe obstructive lung disease.

Normal volume but difficulty getting air out (asthma)

5

Describe restrictive lung disease.

Decreased lung volumes (scarring /fibrosis in lungs)

6

Name 5 ways of investigation of a patient with lung disease.

• Chest x-ray +/- CT scan
• Hb, white cell count etc
• Arterial blood gases (pO2, pCO2, pH)
• Physiology (spirometry, pulmonary function tests)
• Bronchoscopy +/- biopsy and lavage

7

what is the lungs function?

to facilitate transfer of O2 to blood and CO2 in the other direction

8

What is type 1 respiratory failure?

decreased arterial pO2

9

What is type II respiratory failure?

decreased arterial pO2 plus increased arterial pCO2

10

which is worse of the two respiratory failures?

Type II - pulmonary function is terminal

11

What does decreased Pa O2 lead to?

• Dyspnoea and increased respiratory rate
• Pulmonary vasoconstriction (and pulmonary
hypertension)
• Eventually right sided heart failure

12

What can cause airway narrowing /obstruction?

• Muscle spasm
• Mucosal oedema (inflammatory or otherwise
• Airway collapse due to loss of support
• (Localised obstruction due to tumour or foreign body)

13

What are the main categories of obstructive disease?

• Asthma
• Chronic obstructive pulmonary disease (COPD/COAD/COLD)

14

What is bronchial asthma?

A chronic inflammatory disorder characterised by hyperreactive airways leading to episodic reversible bronchoconstriction

15

What is extrinsic asthma?

response to inhaled antigen

16

What is intrinsic asthma?

non-immune mechanisms (cold, exercise, aspirin)

17

What is type I hypersensitivity ?

Allergen binds to IgE on surface of mast cells

18

what effects does type 1 hypersensitivity have?

• Degranulation (histamine)
– muscle spasm
– inflammatory cell influx (eosinophils)
– mucosal inflammation/oedema
• Inflammatory infiltrate tends to chronicity

19

Name the types of pathology.

• Narrowed oedematous airways
• Mucus plugs
• Inflammatory cells (lymphocytes, plasma cells, eosinophils)
• Epithelial cell damage

20

What is mucosal oedema?

airways narrowed and blocked by mucous

21

Name 2 types of chronic obstructive disease.

• Chronic bronchitis
• Emphysema

22

what do symptomatic patients have?

Often have both chronic bronchitis and emphysema

23

What is the epidemiology of COPD?

• Smoking
• Atmospheric pollution
• Genetic factors

24

what is the epidemiology definition of chronic bronchitis?

Cough productive of sputum on most days for 3 months of at least 2 successive years

25

what does chronic bronchitis not imply?

airway inflammation

26

What is emphysema?

• Increase beyond the normal in the size of the airspaces distal to the terminal bronchiole
• Without fibrosis
-The gas-exchanging compartment of the lung

27

What is emphysema due to?

“Dilatation” is due to loss of alveolar walls (tissue destruction)
• Appears as “holes” in the lung tissue

28

Discuss the diagnosis and treatment of emphysema.

• Difficult to diagnose in life (apart from in
extremis)
• Radiology (CT) can show changes in lung
density
• Correlation with function known from autopsy studies

29

what is panacinar emphysema?

Tissue destructtion-extreme -big dilated airspaces, loss of tissue between gives illusion of dilation

30

what do emphysema impair?

respiratory function